The Health Effects Of Rescinding Trans Title IX Protection

Last night, Donald Trump rescinded Obama's Title IX guidance that gave federal protections for transgender students. The protection guaranteed students the right to use restrooms matching their gender, not their sex assigned at birth.

Though discriminating against transgender students is still illegal under Title IX, removing the guidance "intentionally creates confusion about what federal law requires," writes Lambda Legal. "The law bars discrimination—the new administration invites it."

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While it's obvious that trans students are being discriminated against, what's often not as clear is the effect that discrimination has on the mental and physical health of those students. Experts agree that discrimination against trans students, such as forcing them to use facilities not matching their gender, leads to stress, depression, and a much harder time learning.

"The law bars discrimination—the new administration invites it."

"Discouraging or punishing children for expressing their true sense of identity threatens their health and well-being, and schools have a special responsibility to protect all young people, regardless of gender identity or expression," said Dr. Diane Horvath-Cosper, Reproductive Health Advocacy Fellow at Physicians for Reproductive Health in a statement following Trump's order.

According to the National Center for Transgender Equality 2015 report, 77% of respondents who were out or perceived as transgender while students said they were mistreated or discriminated against, whether it was by verbal or physical harassment, not being able to wear clothing that expressed their gender, or being expelled.

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This issue is not men or women being forced to use the wrong restroom, but not using the restrooms at all, and thus being denied a basic bodily function out of fear. 59% of all trans people surveyed by the NCTE said they avoided using restrooms at all in public, fearing discrimination or violence, which for some led to health problems like UTIs and kidney infections. 32% said they limited what they ate and drank to avoid having to use the restroom.

59% of all trans people surveyed by the NCTE said they avoided using restrooms at all in public, fearing discrimination or violence

"If a student can't use the right restroom at school, they can't go to school," Mara Keisling, Executive Director of NCTE, told ELLE.com. "This is about kids being able to go to school." Keisling noted that some schools are trying to work around Title IX by creating separate bathrooms for trans students, which tends to make things worse. "That makes you a pariah, because for some reason you can't use the same bathrooms as everybody else, and people notice."

"When we think about places unsafe for trans people bathrooms come up. They're very gendered spaces," says Dr. Katherine Greenberg, Associate Professor of Adolescent Medicine at the University of Rochester, director of gender health services there, and part of Physicians for Reproductive Health's Adolescent Reproductive and Sexual Health Education Program. "The beauty of extending Title IX protections to trans students is it says on a policy level that you are safe. We are committed to working with you to make sure your experience in single gender spaces is safe and comfortable for you." By contrast, rescinding the guidance sends the message that, on a macro level, trans students' safety doesn't matter.

Dr. Greenberg says that even in Rochester, NY, where state laws protect the rights of trans students, her patients often exhibit physical and mental effects related to discrimination. Some report going to the bathroom less, or not going all day, and experience dehydration, constipation, and other physical issues. "The idea that the bathroom is not safe, so you're going to restrict your bladder and bowels, is really extreme, but not at all uncommon. I hear stories about this from my patients all the time, of feeling so anxious and unsafe that they're not able to focus at school."

That sort of stress can lead to anxiety, depression, and suicidal thoughts―which trans people already suffer from at rates far above the national average. In fact, one study tested the link between suicide and access to bathrooms and student housing in colleges, and found that "denial of access to either space had a significant relationship to suicidality, even after controlling for interpersonal victimization."

"If a student can't use the right restroom at school, they can't go to school."

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Policy that protects rights for minorities has the opposite effect. A study in JAMA Pediatrics shows that in states that legalized same-sex marriage, suicide rates among teens were lower, especially for LGB teens. "We know things like having a supportive family and friends can be impactful for individual youth, but so does big picture policy," said Dr. Greenberg.

Rulings that encourage discrimination are coming at a time when there's more visibility for the trans community than ever before. According to Keisling, that's to be expected. "The increased visibility will get us where we need to be. But it puts us in dangerous temporarily. I take it really seriously, but in a certain way, it's part of the process," she said. She cited the old saying "first they ignore you, then they laugh at you, then they fight you, then you win." "Now they're fighting us," she said. "And we're gonna win."

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